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Campaigners say St Paul’s dentist could have reopened sooner, after enquiry went unanswered

NHS denies busy surgery where thousands queued could have stayed open, but residents’ group leaders call for more transparency.

Image of people protesting against the closure of dental care services in St Pauls, Bristol in June 2023 (credit: Alexander Turner)

credit: @alexcarlturner

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The dentistry firm that reopened a practice in St Paul’s earlier this year, making national headlines, enquired unsuccessfully about taking it on months before it closed, the Cable can reveal.

The dentist surgery on Ashley Road was one of more than 80 closed by healthcare giant Bupa after an announcement at the end of March 2023.

Local campaigners battled for months first to keep the doors open and then to ensure services returned to BS2 after thousands of people lost their access to NHS dental care. Now, some are asking whether it needed to stay closed so long.

When the practice reopened in February this year, huge queues stretched around the block to register for three days, starkly demonstrating the desperation caused by the UK’s shortage of dentists. We tell the full story of the campaign this week in the latest edition of our Area in Focus podcast. 

New operator SGA Services praised the campaign group’s work to ensure the surgery and its equipment were kept intact, thanks to agreements made with Bupa and building owner Sovereign Housing Association.

“If they hadn’t have done that, it would have delayed the reopening, and patients would have suffered a lot,” said Shivani Bhandari, one of SGA’s directors, adding that her firm would still have sought to take on the practice.

A missed opportunity?

SGA, based in the South West, has two other practices delivering NHS services including one in Southmead that the firm reopened several years ago.

The company first expressed an interest in taking over the St Paul’s practice soon after Bupa revealed its plans to close services.

But Bupa did not respond to the email – and negotiations only began four months later when Bhandari contacted then-councillor Amirah Cole, who was helping lead the campaign, as well as the integrated care board (ICB) that commissions NHS services.

By this point the St Paul’s surgery had been shut for several weeks and would remain closed for a further six months.

As it was winding up, dozens of people contacted the Cable to share their struggles to access another NHS dentist – and their fears for the future. Amid the national crisis in dental care, Bristol is one of the worst areas, with a 2022 BBC investigation finding that 98% of practices were not accepting new adult NHS patients.

Bhandari said she did not blame Bupa over the drawn-out process.

But Cole – whose family had been patients for decades at the dentist – said the saga showed the need for greater transparency around how crucial healthcare services operate and can be withdrawn from communities. It took months of action by the campaign group before members gained a seat round the table with the organisations that had power to influence the future of the practice.

“As less and less money comes [into public services], the roads that lead between community groups and the people who deliver services are also getting less,” Cole said. “So what needs to happen is there needs to be that road in, [people] need to be able to give feedback, they need to be able to have their say, and they need to be able to get their voices heard.”

Cole, who lost her city council seat representing the Ashley ward in May’s local elections, added that she was “always optimistic” dentist services would be brought back to St Paul’s. “It was not going to happen on my watch – [the group] had really sat down and looked at who we were targeting,” she said.

But she said the months during which the surgery had remained closed had already seen large numbers of people suffering due to the absence of dental care. Many complained that they had no contact from Bupa to warn them services were shutting down.

“I find it really difficult to swallow that [providers] can be serving so many people and just walk away,” Cole said. “Although the campaign has been successful, [it seems] so unnecessary the harm people have been forced into, when a provider had approached Bupa.”

‘Surgery reopened by the fastest route’

In a statement to the Cable, Bupa did not directly answer a request for information about how SGA’s message had not been responded to.

A spokesperson for the ICB said the commissioning body could not comment on discussions between SGA and Bupa, but said Bupa had followed all contractual regulations and obligations when terminating their contract.

“When we were aware of SGA’s offer of support, we discussed what support Bupa could offer with the reallocation of the contract activity, in relation to what equipment, fixtures and fittings would remain,” the spokesperson said.

The spokesperson said that even if the first enquiry had been answered immediately, the surgery could not simply have remained open because a sale would have had to take place between SGA and Bupa.

“Due to procurement regulations SGA would not have been in the position to just expand their NHS services, they would have had to follow one of [three] routes,” they added. These are a sale, a formal tender or a direct award of the contract – which was what eventually happened in late 2023.

“As it stands, the actions taken by following the direct award route were in fact the fastest and most effective manner of getting the contract reallocated and mobilised,” the spokesperson said. “This reflects the particular circumstances in St Paul’s and each circumstance needs to be tested against procurement regulations going forward.”

Since reopening, SGA has enrolled around 2,000 people, many of them former patients. At the turn of the new year, the campaign group went door to door around the neighbourhood to ensure local people knew the practice was reopening and when.

Tara Miran, one of the campaign leaders, said that while the months-long effort had been exhausting and at times frustrating, the end result was worth it.

“The bigger reward is, what have I done for my community and with my community?” she said. “If I see one person going to the dentist now and she comes back out with a smile, that’s it – job done.”

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